Comment on CMS-2026-1916-0001

Indigenous Women Rising appreciates the opportunity to comment on this proposed rule. Medicaid plays a critical role in ensuring access to healthcare for millions of people, including low-income families, pregnant people, individuals with disabilities, and rural communities. As CMS considers changes to State Directed Payments and targeted fee-for-service practitioner payments, it is important to recognize the role these supplemental payments play in supporting providers that serve a large Medicaid population. Many hospitals, clinics, and specialty providers rely on these payments to help sustain services that are often reimbursed below the cost of care. Placing new limits on supplemental payments could create financial challenges for providers, particularly in rural and medically underserved areas where access to care is already limited. Reductions in provider funding may result in fewer available services, longer wait times, or increased travel for patients seeking care. We encourage CMS to carefully evaluate the potential effects of the proposed payment limits on healthcare access before finalizing the rule. Any changes should preserve the financial stability of providers serving Medicaid beneficiaries while promoting transparency and accountability within the Medicaid program. Thank you for the opportunity to submit these comments.